acquisition

In a merger that brings together two Florida real estate investment firms, Boca Raton-based Kayne Anderson Real Estate Advisors said Thursday that has agreed to acquire Sentio Healthcare Properties.
The all-cash deal has an estimated total asset value of $825 million.
Kayne Anderson, the real estate private equity arm of Kayne Anderson Capital Advisors, invests in off-campus student housing, senior housing and medical office buildings. Publicly-traded real estate investment trust Sentio, based in Orlando, has a portfolio of 34 properties including senior housing communities and medical office buildings in 16 states across the country.
Under the terms of the agreement, Sentio stockholders will receive between $14.37 to $15.22 per share in cash, depending on certain conditions, according to a release. The deal is subject to Sentio shareholders’ approval and is expected to close in the third quarter.
Source: The Real Deal

Boca Regional-Marcus Neuroscience Institute

During the next five years, Boca Raton Regional Hospital may change as much or more than it has in the previous 50 years.
The hospital’s proposed parking garage—more about that in the next item—is the first of four projects designed to transform Boca Regional. The others are a second tower, new operating rooms and a new power plant. CEO Jerry Fedele estimates the cost at $260 million.
Fedele came in 2008 as the third CEO in 10 months. The hospital had lost $120 million, mainly stemming from the attempt two years earlier to create a $600 million academic center. After Fedele and the team he brought stabilized the finances, they changed the name from Boca Community to Boca Regional.
Since then, the hospital’s core market has expanded beyond the city. Vice President Dan Sacco said the market now runs from Pompano Beach in Broward County to Lake Worth. As the market has grown, so has Boca Regional’s share of the market. Even as competitors tout their emergency rooms, Boca Regional has grown from 35,000 annual ER visits to 55,000. Previously, Fedele said, only about 100 of the roughly 400 beds might be occupied on an average day in the summer. “Now, we’re at 300-plus consistently. We’re much less seasonal.” He and I spoke last Thursday. The day before, Fedele said, “We were full.”
Meanwhile, in the last 11 years Boca Regional has started an open-heart surgery center and opened the Eugene M. & Christine E. Lynn Cancer Institute, the Marcus Neuroscience Institute and the Christine E. Lynn Women’s Health & Wellness Institute. A new robotic surgery program has three such devices that cost $2 million each. The Gloria Drummond Physical Rehabilitation Institute—named for the woman whose family tragedy led her to found the hospital— will open this year.
So Boca Regional has a stunning list of outpatient services, but what Fedele calls “capacity problems” for inpatient services. Many rooms are still semi-private, and what Fedele calls the hospital’s increasingly “sophisticated patient population” wants is private rooms. Over the last seven years, he said, Boca Raton Regional Hospital “has fundamentally changed.”
Accordingly, the projects will help the hospital meet those new demands. Eighty percent of the beds will be private. In practical terms, Fedele said, the hospital operates with 350 beds. If Boca Regional can replace the parking lot with the garage, it will shorten the distance patients must travel to the main entrance. Most would get there by using an air-conditioned bridge.
The new tower would be on the north side, out to Meadows Road, and the hospital would renovate the existing tower. Fedele would like work on the garage to begin next spring and be finished by the start of high season, and for work on the towers to begin in 2019.
In almost any other similarly sized area of the United States, much of this would not be possible. Fedele said Boca Regional ran a surplus of between $7 million and $10 million in its most recent budget year on revenue of about $450 million. At non-profit hospitals, Fedele said, health care is a low-margin business. Because of the philanthropic base in and around Boca Raton, however, the hospital doesn’t have to pay for the improvements out of its operating surplus.
But while retaining that community identity, Boca Regional has widened its appeal and reputation. Affluent snowbirds who once flew home for advanced care are having it here. Turmoil at the North Broward Hospital District makes Boca Regional a better option for patients south of the county line. The relationship with Florida Atlantic University’s medical school is growing.
Between the planned improvement and the new programs, nearly half a billion dollars could flow into Boca Raton Regional Hospital over 15 years. How lucky that protests 20 years ago prevented the board at that time from selling the hospital. Despite that fundamental change, Boca Regional remains Boca’s own.

Hospital Garage

The hospital’s proposed garage got a favorable recommendation from the Boca Raton Planning and Zoning Board, but the neighbors aren’t happy.
Before the 4-2 vote, homeowners who live across the canal from the current parking lot complained about potential noise, exhaust fumes and excessive light. Some said their property values have been dropping and would drop if the hospital got permission to replace the roughly 200 surface spaces with 900 spaces in a 50-foot garage that could be 100 feet from their homes, rather than the 250 feet that otherwise would be required.
Some speakers made unreasonable suggestions. Example: build the garage on the north, which would force patients to cross Meadows Road. Some wondered if the garage would benefit employees more than patients, since the hospital moved about 300 employees from the lot to the nearby garage at Oaks Plaza on Glades Road. A hospital representative said “some” employees would return.
Mostly, though, the neighbors don’t like the size and the proximity. Indeed, 100 feet is pretty close. But as I reported last week, the hospital could build its planned second tower at that location. The tower would be nearly 150 feet tall. Property records show that values of the homes across the canal have been rising, not falling. Though Boca Regional was much different when it opened in 1967, the hospital likely predates many of the homes.
And the need is obvious. Board member Janice Rustin noted the times that she had been unable to find a parking space. Boca Regional also is not the usual developer seeking a change from the city. The hospital holds near-iconic status, which was reflected in the comments from some board members.
Still, the neighbors likely will turn out in big numbers when the proposal goes to the city council. That could happen next month.
Source: BocaMag

waiting room

In the “old days,” medical and dental waiting offices were usually somewhat functional, but certainly not patient-friendly. The chairs were painful, the working space was non-existent, the lighting was cruel and unusual, and you were lucky to find a magazine from the current decade.
Time has changed! These days, savvy practice leaders understand that making their waiting room a place where patients want to remain — rather than are forced to be — is not just good manners, but it is also a good strategy. Indeed, fostering patient loyalty and generating referrals are essential for a healthy (no pun intended!) bottom-line. A waiting room that is memorable for all of the right reasons vs. the wrong ones supports both of those critical objectives.
With this in mind, here are four best practice for medical and dental waiting room office design that can make a significant, and in some cases dramatic – difference to patient satisfaction rates, roster sizes, and overall practice profitability:

1. Emphasize the “Room” Aspect of Waiting Room

Some waiting rooms are pleasant esthetically and have some nice enhanced features (we will explore some of these shortly), but they cram patients together like proverbial sardines. Removing or repositioning chairs, tables, and other furniture can turn space maximization into space optimization — which is the real priority.

2. Comfort Matters More than You Think

Let’s be frank! Most folks do not want to spend time at their dentist or doctor. There is nothing personal in this, of course. Even when even patients are about to experience something positive and exciting ( like a smile makeover or an auxiliary cosmetic treatment that they have been craving for years ), there are, oh, about 8000 other places give-or-take that they would rather be. It is just the nature of things.
Smart practice leaders understand this sentiment and make their waiting room a warm, welcoming, and above all comfortable place to be. For instance, they ensure that the furniture is ergonomic and cozy, that adult patients can watch HDTV or log onto free wifi, that kids have toys and video games to help them ( and their parents ) forget where they are, and so on.

3. Administer some Color Therapy

Color has a significant impact on mood, which is why some corporations spend an enormous amount of money picking and choosing colors and color schemes for their logos, websites, lobbies, and so on. Dental and medical office design should indeed borrow from the color therapy playbook by making strategic ceiling, wall and flooring choices. For example, blue is viewed as comforting and calming, which is why it is predominant in many modern practices.

4. Connect Patients with Staff

Last but not least, some patient waiting rooms are located in areas that are not visible by practice reception staff. This can create a disconnect (think of a hospital) that leads to patient discomfort and disengagement, and in some cases, may cause patients to exit the roster. For example, a patient in a dental office may be visibility anxious about an imminent treatment and is jumping out of her seat every time she hears the dreaded “drill” sound. If a staff member sees this, they can intervene and say something comforting and calming. This small but meaningful gesture can make all of the difference.

The Bottom Line

Perhaps the thing that most needs to change about dental and medical office waiting rooms is the term “waiting room” itself. Yes, it is the place where patients wait. But it is far more than that. It is also the area where they form impressions, draw conclusions and establish memories about practice. In this sense, calling it a “patient win or lose room” is much more apt, because it is that important and influential.
Source: Prague Post

small scale hospitals

Despite uncertainty over the future of healthcare reform, demand for healthcare services will rise within the next few decades. Aging Baby Boomers are demanding more care and will make up one out of every five people by 2050. Since 1993, outpatient visits nearly doubled, according to a report from JLL. Check out five trends affecting healthcare real estate this year.

1) More Small Scale Hospitals

Much like the rapid expansion of urgent care and retail clinics, micro-hospitals are arising in metro settings to provide additional healthcare options. These facilities are basically full-service hospitals on a small scale and provide emergency care, inpatient care, some surgical procedures and often labor and delivery services. The two- to three-story 35K to 45K SF micro-hospitals increasingly cropped up in 2016 with many health systems partnering with Emerus, the nation’s first and largest operators of these hospitals.
San Francisco-based Dignity Health has been opening micro-hospitals in Phoenix and Las Vegas. SCL Health has micro-hospitals in the Denver area, while Baylor Scott & White Health has several throughout Texas.

2) More Expansion Of Existing Sites

Health systems are opting for expansions of existing sites rather than building new facilities this year to save money. Expansions take less time and capital, allowing health systems to provide expanded services faster. Expanding services at an already popular location is also ideal since the site has already proven to be accessible, according to Duke Realty.
UCSF Benioff Children’s Hospital Oakland, for example, is in the process of a 10-year expansion plan, which will add a six-story 89K SF outpatient clinic. The plan includes a renovation of the main hospital that will increase beds to 210 and add additional services.

3) Health System Consolidation

Even though health systems are expanding their hospitals, there will be fewer independent hospitals and health systems within the next decade. Deloitte expects half of the non-government health systems, a total of 1,833 in 2014, will exist by 2024 and there will be no independent hospitals in 2024.

4) New Leasing Arrangements

New accounting rules set up by the Financial Accounting Standards Board will dramatically affect how providers structure their leasing arrangements. Under the new rules, which will go into effect in the next two to three years, providers will have less flexibility in how they classify their leases, according to Becker Hospital Review. Providers are currently able to classify long-term leases as operating leases and providers have the option of sale-leaseback arrangements without an impact on balance sheets.
Under the new rules, leases will be classified as financing leases, which are like debt on the lessee’s balance sheet. These rules have had providers rethink their leasing arrangements and whether they want to own or lease a newly built facility. Developers are starting to offer alternatives such as credit-tenant leasing arrangements, where a provider gets the benefits of ownership when the lease expires.

5) More Rehab Hospitals

Hospitals and health systems are considering offering more post-acute rehabilitation services or to partner with an experienced rehab hospital operator as a way to avoid steep readmission penalties for preventable conditions. Through an experienced operator, hospitals can provide improved post-discharge patient care, better cost efficiency and speed to market, according to Duke Realty.
Source: Bisnow

cleveland clinic

Rendina Healthcare Real Estate obtained a $26.6 million construction loan to break ground on the Cleveland Clinic outpatient facility in Coral Springs.
New Jersey-based Siemens Financial Services awarded the mortgage to Coral CC Investors, an affiliate of Jupiter-based Rendina Healthcare Real Estate. The developer recently acquired the 5.2-acre site at 5701 N. University Drive — near the Sawgrass Expressway — from Cleveland Clinic Florida for $3.2 million. The new building will be leased to Cleveland Clinic.
The nonprofit health care organization held the ground breaking ceremony for the 72,000-square-foot facility on April 3. It will include family health services, ambulatory surgery with six operating rooms, imaging equipment such as CT/MRI, mammography and X-ray, 24 prep/recovery bays and 40 exam rooms.
This will be Cleveland Clinic’s eighth facility in South Florida. The hospital is also expanding its main campus in Weston.
Source: SFBJ